BILL ANALYSIS Ó
SB 914
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Date of Hearing: June 22, 2016
ASSEMBLY COMMITTEE ON INSURANCE
Tom Daly, Chair
SB
914 (Mendoza) - As Introduced January 26, 2016
SENATE VOTE: 36-0
SUBJECT: Workers' compensation: medical provider networks:
independent medical reviews
SUMMARY: Repeals outdated references to certain medical
treatment guidelines. Specifically, this bill deletes several
references to the American College of Occupational and
Environmental Medicine's (ACOEM) treatment guidelines from the
Labor Code.
EXISTING LAW:
1)Establishes a comprehensive system to provide benefits,
including medical treatment, to employees who are injured or
suffer conditions that arise out of or in the course of
employment.
2)Requires treatment to be evidence-based, as detailed in a
Medical Treatment Utilization Schedule adopted and maintained
by the Administrative Director (AD) of the Division of
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Workers' Compensation (DWC).
3)Required, subsequent to the 2004 workers' compensation
reforms, that the ACOEM guidelines be utilized when making
medical treatment decisions, until such time as the AD adopted
alternative guidelines.
4)Continues to reference ACOEM despite the AD having adopted
alternative guidelines.
FISCAL EFFECT: Undetermined; the bill is keyed non-fiscal by
Legislative Counsel.
COMMENTS:
1)Purpose. According to the author, the DWC has suggested that
the Labor Code be cleaned up to reflect the fact that the
references to ACOEM are no longer accurate, and could
potentially be confusing. The bill is the author's effort to
accomplish this goal.
2)Background. In 2004, the Legislature passed SB 899
(Poochigian), Chapter 34, Statutes of 2004, which was a major
reform of the California workers' compensation system. As a
part of that reform, SB 899 required the DWC to create an
evidence-based set of medical guidelines to ensure that
injured workers were receiving consistent, appropriate
treatment from physicians. In the intervening period, SB 899
required that physicians use the ACOEM guidelines, which are a
set of widely-utilized evidence-based, peer reviewed medical
guidelines that continue to be used in California's workers'
compensation system and many other state workers' compensation
systems.
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In 2009, the DWC promulgated the California-specific workers'
compensation system medical treatment guidelines known as the
MTUS. The MTUS utilized many of the chapters that make up
ACOEM, but also referenced additional guidelines or developed
independent guidance on medical treatment. As such, while
ACOEM is still used as a part of the MTUS, it no longer
operates as a stand-alone guideline, and the references to it
in the Labor Code can be confusing and cause practitioners to
fail to refer to the MTUS.
REGISTERED SUPPORT / OPPOSITION:
Support
None received
Opposition
None received
Analysis Prepared by:Mark Rakich / INS. / (916)
319-2086
SB 914
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